Multimodal MRI profiling of focal cortical dysplasia type II
Multimodal MRI profiling of focal cortical dysplasia type II
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DOI：
10.1212/wnl.0000000000003632
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发表时间：
2017-02-21
期刊：
影响因子：
9.9
通讯作者：
Bernasconi, Andrea
中科院分区：
文献类型：
--
作者：
Hong, Seok-Jun;Bernhardt, Boris C.;Bernasconi, Andrea
目的：通过对局灶性皮质发育不良(FCD)IIA和IIB型病变的形态、强度、显微结构和功能的联合分析，探讨其在体内的MRI特征。方法：对33个经组织学证实的FCD IIA(9)和IIB型(24)病变进行多模式3T磁共振成像。在手动共识标签上操作的多表面方法系统地采样了皮质内和皮质下的皮损特征。测地线距离图量化了病变周长内的相同特征。Logistic回归分析MRI与组织学之间的关系，监督模式学习用于个体化亚型预测。结果：IIB型FCD表现为形态、强度、弥散率和功能的异常，而IIA型仅表现为灰白质界面附近液体衰减的反转恢复信号增加和弥散各向异性降低。与皮损类型相似，病变周围异常在延伸至16 mm的IIB型中更为明显。结构性MRI标记物与分类组织学特征相关。基于轮廓的分类器预测FCD亚型的灵敏度为85%，同时对健康和疾病对照组保持94%的高特异度。结论：图像处理应用于广泛使用的MRI对比剂，能够在中观水平上分离FCD亚型。将病理特征的活体分期与自动病变检测相结合，可能会提供病变边界的客观定义，并有助于新兴的方法，如不提供组织标本的微创热消融。
Objective: To characterize in vivo MRI signatures of focal cortical dysplasia (FCD) type IIA and type IIB through combined analysis of morphology, intensity, microstructure, and function.Methods: We carried out a multimodal 3T MRI profiling of 33 histologically proven FCD type IIA (9) and IIB (24) lesions. A multisurface approach operating on manual consensus labels systematically sampled intracortical and subcortical lesional features. Geodesic distance mapping quantified the same features in the lesion perimeter. Logistic regression assessed the relationship between MRI and histology, while supervised pattern learning was used for individualized subtype prediction.Results: FCD type IIB was characterized by abnormal morphology, intensity, diffusivity, and function across all surfaces, while type IIA lesions presented only with increased fluid-attenuated inversion recovery signal and reduced diffusion anisotropy close to the gray-white matter interface. Similar to lesional patterns, perilesional anomalies were more marked in type IIB extending up to 16 mm. Structural MRI markers correlated with categorical histologic characteristics. A profile-based classifier predicted FCD subtypes with equal sensitivity of 85%, while maintaining a high specificity of 94% against healthy and disease controls.Conclusions: Image processing applied to widely available MRI contrasts has the ability to dissociate FCD subtypes at a mesoscopic level. Integrating in vivo staging of pathologic traits with automated lesion detection is likely to provide an objective definition of lesional boundary and assist emerging approaches, such as minimally invasive thermal ablation, which do not supply tissue specimen.